Tag Archives: Reno Dentistry

Are White Fillings Harmful to Kids?

Recently, white fillings (tooth colored)  came under fire for possibly contributing to poor behavior in kids. The media has highlighted that the BPA (bispenol A) containing fillings had a small but significant correlation to behavior issues in children.  The point not highly emphasized was that the level of BPA released from whiteReno Dentist - Tooth Colored Fillings fillings in the mouth was not measured.  It is not known what, or if, any chemicals are actually being released from these fillings. “It’s generally assumed that the amounts leached are tiny”1 Children with multiple white fillings, according to this study, constantly scored up to 6 points worse on a behavior survey answered by their parents.1  Effects from BPA have been noted as being “far from clear,” even looking back to a story from Reuters late October 2011. 

Important Points to Consider about Dental Fillings:

1.  Dental caries is a preventable disease by practicing good oral hygiene habits, limiting exposure to dietary acids (citric acid) and sticky sugars (dried fruits), and keeping regular dental cleaning appointments.

2. White fillings are primarily a silicate glass which is bound by a resin containing small amounts of BPA, which levels of BPA release have not been measured.

3. Silver Amalgam fillings are an alternative to white dental fillings, but a little more tooth is removed in the preparation.  Though it is one of the most researched dental materials and deemed safe by the ADA, they contain small amounts of mercury, and these fillings have been known to discolor and darken teeth. 

4. Any concerns you may have should be discussed with your dentist.


Tooth fillings made with BPA tied to behavior issues

BPA tied to behavior problems in girls: study


Osteoporosis and Bisphosphonates – Bone Loss is Not Your Only Concern

Oral health is not commonly found in the forefront of everyone’s mind when we think of osteoporosis. For those at risk for osteoporosis, it should be something you not only discuss with your doctor but your dentist as well. Loss of bone in the mouth leads to loss of teeth, which makes it more difficult to properly nourish your body. There are many treatments used to address osteoporosis, but some such as Bisphosphonates severely impact you mouth. Bisphosphonates, such as Fosamax, Boniva, Actonel, and Reclast place a person at risk of developing osteonecrosis of the jaw which means a person’s gum tissue is not fully covering the bone leaving it exposed to the oral environment. This condition is difficult to treat, so if you need to be placed on Bisphosphonate treatment it would be best to see your dentist beforehand to make sure there are not any compromised teeth or teeth that need to be removed. The trauma associated with tooth extraction combined with use of bisphosphonates can lead you down the path of non-vital bone. While the exact cause is unknown, it is thought to be due to possible infection, the jaw’s limited ability to repair itself, or decreased vascularity of the jaw. Bisphosphonates reduce your bone’s ability to turn over so the constant production of bone reduces the blood supply due to the increased bone density. Recently it has been noted that use of bisphosphonates may increase a person’s risk of dental implant failure. A study conducted at the New York College of Dentistry found that women with dental implant failure were about 3 time more likely if they were taking oral bisphosphonates. Managing osteoporosis is a team effort and you should be seen by your dentist on a regular basis to preserve your oral health.

For More Information:

Implant failure may be related to bisphosphonate use

Osteonecrosis of the Jaw (ONJ)

All Ceramic Crowns vs. Gold Crowns

The other day I was talking with a colleague and he asked me if I really felt confident placing all ceramic restorations for posterior teeth such as molars. We graduated from a dental school that taught heavily, that gold is the best restoration for teeth. Gold has great properties that make the cast restoration strong, as well as kind to the opposing teeth and soft tissue. Gold use to be considered esthetic and a symbol of status in some cultures, but as times change patients want white teeth and in some cases metal free restorations. Historically ceramic has been known to be abrasive on opposing teeth and at risk for fracture, but materials and manufacturing are constantly improving making a ceramic restorations a more reliable choice when restoring teeth. Since all ceramic restorations are relativelTwo Molars that have been treated with two all ceramic IPS e.max crownsy new to dentistry, compared to gold and silver, there is limited but promising research for all ceramic restorations. The porcelain that has traditionally been stacked on metal copings can withstand a force of 140 Mpa, and has been used for decades. The all ceramic crowns made from a monolithium disilicate referred to as IPS e.max can withstand forces of 360-400 Mpa. That is more than twice the strength of the porcelain that has been used in the past. Since there is not a metal coping under the ceramic structure of the IPS e.max, there can be better esthetics due to improved translucency, and the restoration can be bonded to the tooth.

In the International Journal of Prosthodontics from January/February 2012, a 10 year study was published finding a survival rate 93.5%. Patient satisfaction was also evaluated and it showed that 96% rated them excellent while the other 4% rated them as good. Though it is tough to compete with the durability of gold, people want something that is white and going to last a long time and IPS e.max is rapidly becoming a material of choice. Reported by Millennium Research Group, 40% of all ceramic restorations are fabricated by CAD/CAM technology and by 2015 it is projected to be 70%. All ceramic restorations are here to stay and thanks to technology like the CEREC and E4D people can get more of their dental work done in one visit instead of having to come back two weeks later after battling a temporary crown. More examples of IPS e.max restorations can be seen in our photo gallery to the right.

For more information check out:

  1. Journal of the American Dental Association
  2. All-ceramic Restorations Shine in Long-term Study
  3. Ceramic Restorations to Top Market by 2015